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Dual-Phase Dual-Energy CT in Patients Treated with Erlotinib for Advanced Non-Small Cell Lung Cancer: Possible Benefits of Iodine Quantification in Response Assessment
J. Baxa, T. Matouskova, G. Krakorova, B. Schmidt, T. Flohr, M. Sedlmair, J. Bejcek, J. Ferda,
Language English Country Germany
Document type Journal Article
NLK
ProQuest Central
from 1997-01-01 to 2017-12-31
CINAHL Plus with Full Text (EBSCOhost)
from 2008-01-01 to 1 year ago
Medline Complete (EBSCOhost)
from 2000-01-01 to 1 year ago
Nursing & Allied Health Database (ProQuest)
from 1997-01-01 to 2017-12-31
Health & Medicine (ProQuest)
from 1997-01-01 to 2017-12-31
- MeSH
- Erlotinib Hydrochloride therapeutic use MeSH
- Iodine MeSH
- Middle Aged MeSH
- Humans MeSH
- Lymphatic Metastasis MeSH
- Lymph Nodes diagnostic imaging MeSH
- Lung Neoplasms drug therapy pathology MeSH
- Carcinoma, Non-Small-Cell Lung diagnosis drug therapy secondary MeSH
- Tomography, X-Ray Computed methods MeSH
- Positron-Emission Tomography methods MeSH
- Antineoplastic Agents therapeutic use MeSH
- Reproducibility of Results MeSH
- Aged MeSH
- Neoplasm Staging * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
OBJECTIVES: To investigate the relationship of dual-phase dual-energy CT (DE-CT) and tumour size in the evaluation of the response to anti-EGFR therapy in patients with advanced non-small cell lung cancer (NSCLC). METHODS: Dual-phase DE-CT was performed in 31 patients with NSCLC before the onset of anti-EGFR (erlotinib) therapy and as follow-up (mean 8 weeks). Iodine uptake (IU; mg/mL) was quantified using prototype software in arterial and venous phases; arterial enhancement fraction (AEF) was calculated. The change of IU before and after therapy onset was compared with anatomical evaluation in maximal transverse diameter and volume (responders vs. non-responders). RESULTS: A significant decrease of IU in venous phase was proved in responders according to all anatomical parameters (p=0.002-0.016). In groups of non-responders, a significant change of IU was not proved with variable trends of development. The most significant change was observed using the anatomical parameter of volume (cut-off 73 %). A significant difference of percentage change in AEF was proved between responding and non-responders (p=0.019-0.043). CONCLUSION: Dual-phase DE-CT with iodine uptake quantification is a feasible method with potential benefit in advanced assessment of anti-EGFR therapy response. We demonstrated a decrease in vascularization in the responding primary tumours and non-significant variable development of vascularization in non-responding tumours. KEY POINTS: • Dual-phase DE-CT is feasible for vascularization assessment of NSCLC with anti-EGFR therapy. • There was a significant decrease of iodine uptake in responding tumours. • There was a non-significant and variable development in non-responding tumours. • There was significant difference of AEF percentage change between responders and non-responders.
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- $a OBJECTIVES: To investigate the relationship of dual-phase dual-energy CT (DE-CT) and tumour size in the evaluation of the response to anti-EGFR therapy in patients with advanced non-small cell lung cancer (NSCLC). METHODS: Dual-phase DE-CT was performed in 31 patients with NSCLC before the onset of anti-EGFR (erlotinib) therapy and as follow-up (mean 8 weeks). Iodine uptake (IU; mg/mL) was quantified using prototype software in arterial and venous phases; arterial enhancement fraction (AEF) was calculated. The change of IU before and after therapy onset was compared with anatomical evaluation in maximal transverse diameter and volume (responders vs. non-responders). RESULTS: A significant decrease of IU in venous phase was proved in responders according to all anatomical parameters (p=0.002-0.016). In groups of non-responders, a significant change of IU was not proved with variable trends of development. The most significant change was observed using the anatomical parameter of volume (cut-off 73 %). A significant difference of percentage change in AEF was proved between responding and non-responders (p=0.019-0.043). CONCLUSION: Dual-phase DE-CT with iodine uptake quantification is a feasible method with potential benefit in advanced assessment of anti-EGFR therapy response. We demonstrated a decrease in vascularization in the responding primary tumours and non-significant variable development of vascularization in non-responding tumours. KEY POINTS: • Dual-phase DE-CT is feasible for vascularization assessment of NSCLC with anti-EGFR therapy. • There was a significant decrease of iodine uptake in responding tumours. • There was a non-significant and variable development in non-responding tumours. • There was significant difference of AEF percentage change between responders and non-responders.
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